Online citations, reference lists, and bibliographies.
← Back to Search

[First Results Of PET / CT-guided Secondary Lymph Node Surgery On Patients With A PSA Relapse After Radical Prostatectomy].

A. Winter, J. Uphoff, R.-P. Henke, F. Wawroschek
Published 2009 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
PURPOSE CT and MRT are not applicable for the early detection of lymph node (LN) recurrence in prostate cancer. The PET / CT ((11)C-, (18)F-choline) technique can detect lesions >or= 5 mm and allows their topographic localisation. We have analysed positive (11)C-choline PET / CT LN findings in the case of a PSA increase after radical prostatectomy (RPE) histologicaly and documented the developing of PSA. MATERIALS AND METHODS 8 patients with PSA relapse after RPE and lymphadenedtomy (LA) were diagnosed as having LNM by means of (11)C-choline PET / CT. Using PET / CT, metastasis suspicious and nearby LN were openly dissected. Histological and PET / CT results were compared and the postoperative PSA-development was examined. RESULTS Of the metastasis suspicious LN (11) 9 were histologically reconfirmed. All additionally removed LN (12) were correct negative. LNM were mostly (7 of 9) located in the iliaca interna area and pararectal. 6 of 7 patients with histological metastasis detection showed a PSA response. 3 of 6 patients with single metastasis had complete PSA remission (< 0.01 ng / ml, maximum follow-up: 28 months) without adjuvant therapy. CONCLUSIONS (11)C-choline PET / CT could detect LNM with high specificity in our collective. These often lie beyond standard LA area, where they were primarily only resected by use of extended or sentinel LA. Because 3 patients with single LNM reached a complete PSA remission (< 0.01 ng / ml) without adjuvant therapy, the selected collective seems to benefit from secondary LN surgery. Whether or not individual patients can be cured by this surgery has to be demonstrated in a longitudinal study. However, an optimal imaging and experience in LN surgery have to be assured.
This paper references
[EAU guidelines on prostate cancer].
A. Heidenreich (2009)
The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis.
A. Hövels (2008)
Detection of lymph-node metastases with integrated [11C]choline PET/CT in patients with PSA failure after radical retropubic prostatectomy: results confirmed by open pelvic-retroperitoneal lymphadenectomy.
V. Scattoni (2007)
Disease progression and survival of patients with positive lymph nodes after radical prostatectomy. Is there a chance of cure?
P. Bader (2003)
MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study.
Roel AM Heesakkers (2008)
11C-choline positron emission tomography for the evaluation after treatment of localized prostate cancer.
I. D. de Jong (2003)
Limitations of radioguided surgery in high-risk prostate cancer.
D. Weckermann (2007)
Radioisotope guided pelvic lymph node dissection for prostate cancer.
F. Wawroschek (2001)
Histological verification of 11C‐choline‐positron emission/computed tomography‐positive lymph nodes in patients with biochemical failure after treatment for localized prostate cancer
D. Schilling (2008)
Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis.
A. Heidenreich (2002)
Evaluation of [11C]‐choline positron‐emission/computed tomography in patients with increasing prostate‐specific antigen levels after primary treatment for prostate cancer
L. Rinnab (2007)
Incidence of positive pelvic lymph nodes in patients with prostate cancer, a prostate‐specific antigen (PSA) level of ≤10 ng/mL and biopsy Gleason score of ≤6, and their influence on PSA progression‐free survival after radical prostatectomy
D. Weckermann (2006)
Evaluation of [18F]-choline PET/CT for staging and restaging of prostate cancer
D. Husarik (2007)
Noninvasive detection of clinically occult lymph-node metastases in prostate cancer.
M. Harisinghani (2003)
Detection of pelvic lymph node metastases in patients with clinically localized prostate cancer: comparison of [18F]fluorocholine positron emission tomography-computerized tomography and laparoscopic radioisotope guided sentinel lymph node dissection.
A. Haecker (2006)
The clinical usefulness of prostate specific antigen: update 1994.
A. Partin (1994)
Intraindividual comparison of [ 11 C ] acetate and [ 11 C ] choline PET for detection of metastases of prostate cancer
N Oyama (2003)
Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET.
I. D. de Jong (2003)
Multiple vesico-urethral biopsies following radical prostatectomy: the predictive roles of TRUS, DRE, PSA and the pathological stage.
V. Scattoni (2003)
Visualization of prostate cancer with 11C-choline positron emission tomography.
I. D. de Jong (2002)
PET imaging of prostate cancer using carbon-11-choline.
T. Hara (1998)
11C-acetate PET imaging of prostate cancer: detection of recurrent disease at PSA relapse.
N. Oyama (2003)
Detektion einer singulären Metas - tase eines Prostatakarzinoms nach RPEmittels PET - CTund PSA - Norma - lisierung nach Resektion
J Kotzerke (2008)
Is a limited lymph node dissection an adequate staging procedure for prostate cancer?
P. Bader (2002)
Intermediate-term survival results in clinically understaged prostate cancer patients following radical prostatectomy.
W. J. Catalona (1988)
Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term results.
S. Daneshmand (2004)
Positron Emission Tomography/Computed Tomography with F-18-fluorocholine for Restaging of Prostate Cancer Patients: Meaningful at PSA < 5 ng/ml?
M. Heinisch (2005)
Lymph node size does not correlate with the presence of prostate cancer metastasis.
R. Tiguert (1999)
Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography.
M. Picchio (2003)

This paper is referenced by
Semantic Scholar Logo Some data provided by SemanticScholar